In a continuing collaboration between Epic Systems and WHA leadership that began in late 2018, Epic hosted WHA’s Physician Leaders Council (PLC) meeting at its Verona campus. The major topic of discussion was how both organizations can best work together to reduce the electronic health record (EHR) burden on front-line clinicians. The latest estimates of physician burnout in the United States are that 45-54% of physicians are suffering from burnout. Many studies have shown that the EHR is a major contributing factor.
Leaders from Epic’s Physician Well-Being Team presented data contrasting the very different experiences that clinicians have in the U.S. who use the Epic EHR compared to colleagues in other countries.
- U.S. Epic users’ outpatient clinical notes are 3-4 times longer than those of their international colleagues, and the average domestic outpatient clinical note has doubled in length since 2009.
- U.S.-based physicians receive an average of 25 in-basket messages per day compared to less than 10 for their international colleagues and spend significantly more time on the EHR, including “pajama time.” Not surprisingly, physician satisfaction with the EHR experience is much lower in the U.S. compared to abroad.
PLC members and Epic leadership discussed a number of the factors driving this different EHR user experience. In the U.S., use of the EHR to satisfy federally mandated documentation requirements, quality of care reporting requirements, reimbursement justification, pay-for-performance programs, payor incentive programs, as well as the litigation environment, all contribute to the difference in our EHR user experience.
Nonetheless, there has been progress and there is hope for needed change. Data from Epic on clinical note length helped nudge CMS to simplify its clinical note documentation requirements in the 2019 Physician Fee Schedule. Epic recognizes the potential for WHA and its member organizations to use our unified voice in partnership with Epic to advocate for regulatory reform.
Epic and PLC members aslo reviewed tools to help identify physicians who are not using the EHR as efficiently as their peers. Epic has found that a clinician’s ability to personalize his/her EHR and providing refresher training every few years significantly improves physicians’ EHR satisfaction. Epic is rolling out Web- Ex based training and has produced more than 150 teaching videos. In development are a “voice assistant” (think Siri and asking “Epic” to find the latest lipid panel for you) and machine learning with predictive analytics where Epic software will anticipate what a clinician needs based on prior ordering patterns.
PLC members and Epic leaders agree there is significant opportunity for both organizations to work together in advocating for regulatory reform and for spreading best practices in the use of the EHR to reduce clinician burnout. WHA staff and Epic Physician Well-Being Team leaders plan to meet regularly going forward to focus our collaborative efforts on initiatives that reduce the EHR burden on clinicians regardless of which EHR a clinician uses.
The PLC also discussed and made recommendations to WHA staff on other important issues, including: a draft CEO survey on physician leadership; a refresh of WHA’s Physician Engagement and Retention Toolkit; and CME accreditation for WHA’s annual Physician Leadership Development Conference.
If you have questions about WHA’s Physcian Leaders Council or are a WHA member physician leader and would like to participate, contact WHA Chief Medical Officer Mark Kaufman, MD.